November, 2016 - Best Private Hospital in Dubai Al Mankhool | IMH Dubai

Stuttering

What is stuttering? 

Stuttering is a communication disorder in which the  smooth continuous flow of speech is broken by repetitions (I- I -I want), prolongations (lllllet  me go), or abnormal stoppages (no sound silence pauses) of sounds and syllables . There may also be unusual facial and body movements associated with the effort to speak. Stuttering is also called to as stammering. But if you talk effort fully, with multiples disruptions that should be taken into consideration.stutter-2

What causes stuttering? 

There are four factors most likely to contribute to the development of stuttering:

Genetics (approximately 60% of those who stutter have a family member who does also);

Child development (children with other speech and language problems or developmental delays are more likely to stutter);

Neurophysiology (recent neurological research has shown that people who stutter process speech and language slightly differently than those who do not stutter);

and family atmosphere  (high expectations and fast-paced lifestyles can contribute to stuttering).

What is the ratio of males to females who stutter?

Males are affected four times more than females.

I think my child is beginning to stutter.

Should I wait or seek help? It is best to seek ways that you, the parents. How can I help him/her as soon as possible? If the stuttering persists beyond three to six months or is particularly severe, you may want to seek help from a speech-language pathologist who specializes in stuttering right away.

Can stuttering be treated?

Yes, of course there are a variety of successful approaches for treating both children and adults. In general, the earlier, the better……

Shot of a little boy talking to a psychologist

I read about a new cure for stuttering. Is there such a thing? 

There are no instant miracle or treatment cures for stuttering. However, a specialist in stuttering can help not only children but also teenagers, young adults and even older adults make significant progress toward fluency.

Good Sleep is a Reachable Dream

sleep-2

Sleep:

Natural periodic state of rest for the mind and body, in which the eyes usually close and consciousness is completely or partially lost, so that there is a decrease inbodily movement and responsiveness to external stimuli.

Why to Sleep?

It plays a vital role in good health and well-being throughout your life. It protects your mental health, physical health, quality of life, and safety. We spent 33% of our lives in sleep.

Normal requirement:
3   to 5   yrs  —-  10 to 13  hrs
6   to 13 yrs  —-  9   to 11  hrs
14 to 17 yrs  —-  8   to 10  hrs
Adults           —-  7   to 9    hrs

Stages of Sleep

sleep-1Sleep follows a pattern of alternating REM (rapid eye movement) and NREM (non-rapid eye movement) sleep throughout a typical night in a cycle that repeats itself about every 90 minutes. NREM (75% of night): As we begin to fall asleep, we enter NREM sleep, which is composed of stages 1-4. REM (25% of night).

Numbers!
Almost 60 % of total population reports sleep problems at any point of their life time. Roughly 1/3 of general population are having sleep problems at any given time.

Common Sleep Disorders:

Insomnia (initial, middle, terminal insomnias or non restorative sleep).
Sleep apnea.
Restless legs syndrome.
Narcolepsy.

Impacts of Poor Sleep:

sleep-3Persons get irritable and exhausted, easily distracted and often don’t make sound decisions. Sleep deprivation negatively impacts the immune system, may also lead to weight gain, high blood pressure, cancer, heart disease, stroke, diabetes, bone loss and depression Sleep deprivation may also impair learning, memory, alertness, concentration, judgment, problem solving and reasoning, as well as increase your risk of accidents.

Assessment:

    • Keep a sleep log, Polysomnography (sleep lab)
    • How to treat?
    • Sleep hygiene
    • Medicines
    • Behavioral treatments
    • Surgery (OSA)

Sleep Hygiene:

  • Avoid napping during the day.
  • Avoid stimulants such as caffeine, nicotine, and alcohol too close to bedtime.
  • Exercise can promote good sleep.
  • Food can be disruptive right before sleep.
  • Ensure adequate exposure to natural light.
  • Establish a regular relaxing bedtime routine. Associate your bed with sleep.
  • Make sure that the sleep environment is pleasant and relaxing.

Medications: What to know about it?

  • Avoid as much as possible.
  • Always with advice from the specialist.
  • Be cautious about addiction.
  • Avoid driving while on medications.

“Sleep is that golden chain that ties health and our bodies together”

(Thomas Dekker)

Language Problem or Late Talking?

 Our parents are smart. They are really concern about their child talk and how he / she communicate. They also listen to his or her peers who are at same age and may compare what older brothers and sisters did at the same age. This is how our parents mentally compare their child’s performance with other children. They immediately create an impression of whether the child is developing speech & language at normal rate or not.

st3If parents feel that development is slow, they check their impression with the other parents, relatives, and their pediatrician. You probably get an answer such as Oh!! Don’t worry, he / she will outgrow it. Look at my child she was so quiet and now she is a chatter box, give him/her time.

But…… suppose he / she doesn’t? Even after giving adequate time. 

st2You would feel guilty waiting and then finding out that I should have acted earlier. Waiting is so hard, why we have to be frustrated at last . We want the best for our child. What’s a parent to do?

But……. You’re not sure of what to do.

st1It’s hard to say the exact age when they hit speech and language milestones. It varies a lot on factors such as the child’s inborn ability to learn language, other skills the child is learning, the amount speech and language input he/she gets. and how others respond to his/her communication attempts .

Do you praise him/her? Listen to him/her carefully?

These factors can slow down or accelerate the speed of speech and language development of our children. Be aware of the certain factors that may increase the risk of late-talking child in the 18 to 30 month old age range even with normal intelligence.

The sooner The Better

If you are concerned about your child’s speech and language development, you should see a speech-language pathologist. The speech-language pathologist may suggest on early intervention program with follow up sessions. It’s important to have formal therapy sessions in case of severe problems.

Do you really want to wait for him/her to outgrow???Don’t leave a chance which leads you to feel guilty that I would have done with everything I could

To undergo treatment, you have to be very healthy !!!

Drug Safety (Rational and Safe use of Medicines)

“To undergo treatment you have to be very healthy, because apart from your sickness you have to withstand the medicine” (Molière)

pharmacovigilanceDrug safety ( Pharmacovigilance) – The science and activities relating to the detection, evaluation, understanding and prevention of adverse drug reactions or any other drug-related problems.

Why drug safety? – Adverse Drug Reactions are among the top ten causes of mortality. The percentage of hospital admissions due to drug related events in some countries is about or more than 10%. Economic impact Drug related morbidity and mortality expenses exceeded US$ 177.4 billion in the USA in 2000.ADR database shows- No of reports: more than 3.5 million, each year increase ~160,000 / year.safe

Drug safety heavily focuses on Adverse Drug Reactions (ADR), which are defined as any response to a drug which is noxious and unintended. ADR is considered serious if it meets one or more of the following criteria:

  1. Results in death or is life-threatening;
  2. Requires inpatient hospitalization or prolongation of existing hospitalization;
  3. Results in persistent or significant disability or incapacity;
  4. Results in a congenital anomaly (birth defect)

FDA drug categories – A, B, C, D or X

Category A

Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy

Category B

Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.

Category C

Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Category D

There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Category X

Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.

Eg: atorvastatin, warfarin, methotrexate,

Pharmaceutical companies perform clinical trials, testing new drugs on people before they are made generally available to see their risk / benefit profile

Specific Patient Populations

Senior man and daughter at homePregnant woman with daughter

Pregnant and lactating women

A pregnant woman must not take any medication without consulting a specialist about the safety of the medication as it may affect the formation of the fetus. During the period of lactation, mothers should consult professionals before use of any medication because some medications can be excreted in breast milk, which may have a negative impact on the infant.

Children

We should take extreme caution when using any medications for children. The reasons are- the lack of scientific studies and clinical trials needed to evaluate the safety of these medications in this age group and also their vital organs are not mature, and thus exposure to certain medications may lead to toxic side effects as the body is mostly unable to fully metabolize or excrete the drugs.

Old people

This group is considered to be most vulnerable to the effect of medications and so it is very important to consider their health status before prescribing any medication, for several reasons. The physiological functions of many body organs decline with age, especially important organs such as the liver and kidneys. Older people can suffer from many chronic illnesses, such as high blood pressure, diabetes, and high blood cholesterol and lipids, possibly necessitating the chronic use of multiple medications, which may conflict with each other.

Drug interactions

Every patient must ensure they are aware of all necessary information regarding those drugs, as well as the possibility of interactions with other drugs or certain food types, through consulting the pharmacist or physician. Groups that are at extreme risk and exposure to those drug interactions include: Patients who use multiple medications, Elderly patients, Patients with multiple chronic diseases and illnesses

Ensuring drug safety

Drug safety is the main aspect of medical therapy that can play a major role in deciding which drug should be given to a patient. Considering the concept of benefit–risk balance drugs with a high risk profile should be avoided unless needed. Personalized medicine should be considered when medications are given to patients.

It is possible to avoid these side effects by using the drug in the proper way, and by following the instructions included in the drug leaflet or provided by the pharmacist or the physician. Knowing the necessary information about a medicine is considered the first step in avoiding side effects.

The risks from medications could be minimized through patient education about drug safety and openness with the patient, allowing him/her to ask questions related to their disease or medications. A good relationship between the medical team and the patient is one of the most important determinants for drug safety.

“Dying from a disease is sometimes unavoidable. But, dying from an adverse drug reaction is unacceptable”(Dr. Vladimir Lepakhin)

 
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